Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to traveling and adventures in temporary positions. Assignments in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska have followed. I finished my most recent assignment in Clarinda on May 18. Right now I’m in northern British Columbia, getting a first-hand look at the Canadian system. Any identifiable patient information has been included with permission.

I had call this last Friday, Saturday, and Sunday, and I’m on call again tonight, Wednesday. Over the weekend I saw so many people with possible or definite stroke that my neurologic exam, thorough but a bit rusty on Friday, was polished and speedy by Monday morning.

I have had to do suturing at least once a day for the last week. I do not anticipate robots taking over this part of my job in my lifetime; especially if children are involved.

Stitching people up brings the opportunity to just chat with the patient, and I got the chance to pick the brains of a couple of really expert fisherfolk. The lakes around here hold some lake trout, ling cod, bull trout, and Dolley Varden. One person I talked to has never come back without a fish, and more than one told me about great spots to catch 28 pounders. Of course we call fishing stories just that for a reason. Still, after I bandage the wound, the cell phones come out and the photos of the fish have been very impressive. The most common, and the most successful bait around here seems to be bacon.

Every morning and evening, when I enter and exit the hotel, I see the crews that stay here, too. Of course I expect the seasonal workers: the rail crews, pipeline workers, tree planters, and such. But now I see firefighters rotating off the line, and I have attended a few in the clinic.

Today the raging forest fires brought in the first of what I anticipate will be a long series of people with respiratory problems. Those numbers might take a while to ramp up, but lungs show an acute phase inflammation, over the first few hours to days, and a longer term late phase inflammation that lasts 6 weeks.

The area doesn’t have many roads, and the fires have cut off evacuation routes south. Last week, at the town’s only thrift store (staffed by hospital auxiliary volunteers), Bethany ran into a family who had to flee the fires.